Ask, listen and act to prevent suicide among your family or friends

Anthony Bourdain was always so affable and engaged in life. He seemed like someone I would want for a friend. His death from suicide was tragic but perhaps not entirely a surprise, considering his lifelong depression. I was surprised by the number of callers to the Crisis Clinic of the Peninsulas upset by his death. He seems to have resonated with so many more people than the other recent celebrity deaths by suicides, such as Kate Spade or even Robin William in 2014. Maybe it is because he showed us a world of experiences and convinced us we could have those experiences too. It can be hard to understand how he could have been ill with depression severe enough to lead to suicide.

“Kitsap Community Suicide Prevention Coalition information is at www.kitsapsuicideprevention.org; Crisis Clinic of the Peninsulas is at crisisclinicofthepeninsulas.org.”

Contacts if you need help

At least 80 percent of people who die from suicide experienced symptoms of depression and it is believed that more than 90 percent had a diagnosable mental health issue. Unfortunately, due to the perceived stigma associated with mental illness most people work hard to keep others from knowing how bad depression is. They don’t want to be a burden on those they care about. They really don’t want the sympathy of others. Mostly they don’t want to be patronized with “You are so lucky, what do you have to be depressed about?”

People often do not or cannot accept that depression and mental health concerns are an illness. An illness no different from cancer or diabetes. For some, depression may be the result of life events, while for others it can be chronic. In either case, as depression worsens the individual begins to feel more isolated. Whether the feeling of isolation is real or perceived, it often grows, allowing room for thoughts of suicide.

Suicide is a symptom of deteriorating mental health. For some people the thought of suicide is connected to a life situation. After making it through a difficult time they may never experience thoughts of suicide again. For others, thinking of suicide is a chronic symptom. The thoughts occur daily, if not continuously, unless something is be done to alleviate the pain. Over time friends and family may become used to the individual talking about depression, suicide or isolation, and they do not see when the symptom worsens.

For some, thinking about suicide provides a momentary break from their pain, and if emotional pain is reduced or alleviated, even if only for a moment, the brain holds on to the ideas. The next time a person becomes overwhelmed the brain brings back the thoughts of ending it all, tricking them into holding on to those thoughts for longer periods. The person may begin to develop a tunnel vision where suicide seems to be the only way to end the pain. They start to consider the how and when of suicide. They reach a point when they believe others will be better off or won’t be affected by a suicide, and see dying as the only possible way to escape emotional pain.

It's important to remember that the person who has reached this point may not want to die. They experience an ambivalence between the certainty of death and the desire to continue living. This ambivalence gives us the chance to intervene. When a person reaches the conclusion that they must die, knows when and how it is going to happen, they may find their spirits improving and a desire to reconnect, say goodbye, and make amends. Sudden improvement in a person experiencing depression can be a warning sign.

Once a person reaches this point, what can we do? The Kitsap Community Suicide Prevention Coalition has boiled it down to three simple words: Ask, listen, act.

Ask if a person is thinking about suicide. If you know anyone who seems to be experiencing depression or disconnecting from life, ask. “Are you thinking of killing yourself?” “Are you thinking about suicide?” ”Do you feel trapped, like dying is the only way out?” If the answer is no but you are still concerned, ask again in a different way. “How would you kill yourself?” Simply asking these questions won't plant the idea of suicide as an option, but it may cause them to reach out for help.

Listen to the person, whether their answer is “yes” or “no”. Let them talk about their feelings and remember their feelings are real even if they have developed delusions about the need to die. Acknowledge their feelings, show concern, but not distress. Arguing with them is more likely to solidify their feelings. Trying to make them feel guilt doesn’t work as they already feel guilty and ashamed. While talking to them try to get some information such as how do they plan on killing themselves with questions such as, Do they have the means available? When are they planning to kill themselves? Have they tried to kill themselves before? Have they ever known someone who died from suicide? Remember that it is more important that you let them talk and actively listen then actually getting the answers to these questions.

Act and stay with the person until the crisis passes or they are connected to resources that can help them. That may be a crisis line, a mental health professional, emergency personnel, or hospital emergency room. Your presence is the best assurance of the individual’s safety.

Remember: Ask, listen, act.

Whether you or someone you know is experiencing emotional distress or thoughts of suicide, someone is available to talk at the Crisis Clinic of the Peninsulas, 360-479-3033, or the National Suicide Prevention Lifeline, 1-800-273-TALK (8255). Veterans and Active Duty Service members can call the Veterans Crisis Line at 1-800-273-8255 and select Option 1. Youth in Kitsap County can reach the Oasis Crisis Text line by texting “Coffee Oasis” to 20121. Anyone in the United States can Text HOME to 741741 anytime, about any type of crisis. All of these services are available 24 hours a day.

Want to learn more about suicide prevention or become active in preventing suicide in Kitsap County? The Kitsap Community Suicide Prevention Coalition or the Crisis Clinic of the Peninsulas can provide speakers to any group interested in learning more.